Professional, Case Manager

Full-Time, Exempt

SUMMARY:

This position will utilize the essentials of an integrated Case Management model that includes assessment, planning, implementation, care coordination, monitoring and advocacy to meet the member's comprehensive health needs. Through collaborative efforts the Case Manager will identify the medical and psycho-social needs of designated members, act as a proactive partner to provide appropriate education, resources, and healthcare coaching. The principal role of the position is to engage individual members and communicate with an established interdisciplinary team to create an individualized person-centered care plan. In addition, the position will provide guidance in understanding benefit coverage and navigating the health care delivery system, including but not limited to Medicaid and Medicare benefits. The overall objective is to create solutions to overcome barriers to care and assist members to achieve optimum health and/or improved functional capability through the coordination of quality, cost effective care. The Case Manager will also monitor and review cases with the Medical Director to ensure appropriate outcomes. Other duties as assigned by supervisor.

This position may be worked virtually (remotely from home) within a New York or Vermont residency. Occasional (semi-annual) travel to the Schenectady based headquarter office is required.

POSITION QUALIFICATIONS:

• Current New York State Licensure as a Registered Nurse is required.
• Possession of Vermont licensure is preferred but can be obtained post-hire.
• RN with multiple state licenses is preferred.
• Bachelor's degree in nursing preferred.
• Case Management Certification preferred (ANCC or CCM).

Minimum Experience:

• At least 3 years of recent clinical and Case Management experience.
• Experience with Medicaid and Medicare programs and benefits strongly preferred.
• Certification in Case Management required within 24 months after hire.

Required Skills:

• Excellent oral and written communication skills.
• Demonstrated clinical knowledge including an understanding of population health management and the Case Management process.
• Detail oriented with strong organizational skills including the ability to manage time wisely to meet established deadlines.
• Ability to work in an energetic team environment.
• Experience with situations requiring strict adherence to confidentiality.
• Ability to solve problems while exhibiting clinical judgment and realistic understanding of the current environment.
• Ability to make independent decisions regarding care coordination, and quality of care.
• Must demonstrate understanding of clinical and psychosocial issues that may alter treatment or the care plan. Ability to demonstrate strong judgment when dealing with emotionally charged situations.
• Strong computer skills including working knowledge of Windows and internet-based applications.

About MVP

MVP Health Care is a nationally recognized, not-for-profit health insurer caring for members in New York and Vermont. Committed to the complete well-being of our members and the communities we serve, MVP makes health insurance more convenient, more supportive, and more personal. We are powered by the ideas and energy of more than 1,700 diverse employees from all backgrounds, committed to having a positive impact on the health and wellness of everyone we serve.

At MVP, we are committed to providing competitive employee compensation and benefits packages. The base pay range provided for this role reflects our good faith compensation estimate at the time of posting. Specific employment offers and associated compensation will be made individually based on several factors, including but not limited to geographic location; relevant experience, education, and training; and the nature of and demand for the role.

In addition, we offer a comprehensive benefits package that includes:

• Considerable paid time away from work including PTO (Paid Time Off), sick time, service time off, paid holidays, and floating holidays, allowing you to take time off when it suits you best.
• Competitive 401(k) employer matching and profit-sharing program to help you save for your retirement.
• Low premium health benefits including medical, dental, and vision coverage to support your well-being and that of your family.
• Life insurance and disability coverage to ensure financial security for you and your dependents.
• An array of optional benefit plans such as accident insurance and specified disease coverage to protect you from the unexpected.
• Full tuition reimbursement (up to the IRS limit) for approved courses and programs that support continuous learning.
• A best-in-class employee Well-Being program to support all dimensions of your health and wellness.

MVP Health Care analyzes the latest market data to determine employee compensation. Compensation figures listed in a job posting are subject to change as new market data becomes available. The salary range, other compensation, and benefits information is accurate as of the date of this posting. MVP Health Care reserves the right to modify this information at any time, subject to applicable law. More detailed information about totalcompensation and benefits will be provided during the hiring process.

MVP Health Care is an Affirmative Action/ Equal Employment Opportunity (PDF). We recruit, employ, train, compensate, and promote without regard to race, religion, creed, color, national origin, age, gender, sexual orientation, marital status, disability, genetic information, veteran status, or any other basis, e.g., Pay Transparency (PDF), and the Know your Rights protected by applicable federal, state or local law. Any person with a disability needing special accommodations to the application process, please contact Human Resources at hr@mvphealthcare.com

Please apply and learn more - including how you may become a proud member of our team.

• Headquarters Office, 625 State Street, Schenectady, New York, United States of America